摘要
目的：探讨持续性不卧床腹膜透析（CAPD）患者血清脑钠肽前体（NT - pro - BNP）水平与患者容量状态、心功能指标的关系，分析影响NT - pro - BNP水平的相关因素。方法选取2012年9月—2013年9月在广西医科大学第一附属医院腹膜透析中心随访的 CAPD 患者104例（CAPD 组），同时选取本院体检健康者30例作为对照组。测定 CAPD 组与对照组血清NT - pro - BNP水平；根据腹膜透析液尿素浓度/血尿素浓度（D/ P）值将 CAPD 患者分为高转运（0.82~1.03μmol/ L，n ＝16）组、高平均转运（0.66~0.81μmol/ L，n ＝33）组、低平均转运（0.50~0.65μmol/ L，n ＝48）组及低转运（0.34~0.49μmol/ L，n ＝7）组。比较4组患者血清NT - pro - BNP水平与容量状态及心功能指标的关系，探讨影响NT - pro - BNP水平的相关因素。结果4组患者清蛋白、血磷、高密度脂蛋白、低密度脂蛋白、总胆固醇比较，差异均有统计学意义（P ＜0.05）；4组患者其余指标比较，差异均无统计学意义（ P ＞0.05）。4组患者的总内生肌酐清除率（Ccr）值、D/ P、液体入量、水肿发生率比较，差异均有统计学意义（P ＜0.05）；4组其余指标比较，差异均无统计学意义（P ＞0.05）。CAPD 组患者血清NT - pro - BNP水平为（4813±4360）ng/ L，高于对照组的（51±23）ng/ L，差异有统计学意义（t ＝9.301，P ＜0.001）。4组患者血清NT - pro - BNP水平、左心室射血分数（LVEF）、左心室收缩末期内径（LVESD）、室间隔厚度（LVST）、舒张末期左心室后壁厚度（LVPWT）、左房内径（LAD）比较，差异有统计学意义（P ＜0.05）。相关性分析显示，CAPD 患者血清NT - pro - BNP水平与转运类型呈正相关（r ＝0.617，P ＜0.001）。残肾 KT/ V、残肾 Ccr 值、尿量对NT - pro - BNP水平的影响有统计学意义（P ＜0.05），而肾小球滤过率估计值（eGFR）、腹膜透析透析充分性（KT/ V）�
Objective To explore the relationship of N - terminal - probrain natriuretic peptide（NT - pro - BNP）to blood volume and cardiac function in continuous ambulatory peritoneal peptide（ CAPD） patients. Methods A total of 104 CAPD in PD Center of the First Affiliated Hospital of Guangxi Medical University from September 2012 to September 2013 were enrolled as CAPD group,and 30 healthy subjects as control group. The levels of serum NT - pro - BNP were determined in 2 groups. The patients were divided,according to dialysate urea concentration/ plasma urea concentration（ D/ P） values,into groups A〔high peritoneal transport（PT）group,0. 82 - 1. 03 μmol/ L,n = 16〕,B（high average PT group,0. 66 - 0. 81μmol/ L,n = 33）,C（low average PT group,0. 50 - 0. 65 μmol/ L,n = 48）,D（low PT group,0. 34 - 0. 49 μmol/ L,n =7）. The relations of NT - pro - BNP level with blood volume and cardiac function were compared among groups A,B,C,D to explore the relevant factors influencing the levels of NT - pro - BNP. Results There was significant difference in albumin, phosphorus,high - density lipoprotein,low - density lipoprotein,total cholesterol among groups A,B,C,D（P 〈 0. 05）, but there was not in the other indicators（P 〉 0. 05）. There was difference in total endogenous creatinine clearance rate（Ccr）, D/ P,fluid intake,edema incidence among 4 groups（P 〈 0. 05）,there was no difference in the other indicators（P 〉 0. 05）. NT - pro - BNP level was（4 813 ± 4 360）ng/ L in CAPD group,higher than in control group〔（51 ± 23）ng/ L〕（t = 9. 301, P 〈 0. 001）. Groups A,B,C,D were different in NT - pro - BNP,left ventricular ejection fraction（LVEF）,left ventricular end systolic diameter （ LVESD ）, interventricular septal thickness （ LVST ）, left ventricular posterior wall thickness （LVPWT）,left atrial diameter（LAD）among 4 groups（P 〈 0. 05）. By correlation analysis,NT - pro - BNP was positively correlated with PT types in CAPD（r = 0. 617,P 〈 0. 00
出处
《中国全科医学》
CAS
CSCD
北大核心
2015年第2期166-171,共6页
Chinese General Practice
基金
广西自然科学基金资助项目(2013GXNSFAA019169)
广西壮族自治区卫生厅自筹课题(Z2013033)
关键词
腹膜透析
脑钠肽前体
容量负荷
心功能
Peritoneal dialysis
Brain natriuretic peptide
Load capacity
Cardiac function
